Vol. 9, Issue 3, Part A (2025)

Umbilical hernia repair continues to present challenges in surgical practice, particularly regarding the choice between mesh and non-mesh techniques. This retrospective cohort study examined 287 adult patients who underwent elective umbilical hernia repair at Alexandria General Hospital between January 2019 and December 2023. The study population included 158 patients receiving mesh repair and 129 patients undergoing non-mesh repair, with comprehensive 24-month follow-up data collected through June 2024. The primary endpoint focused on recurrence rates, while secondary outcomes encompassed postoperative complications, operative duration, hospital stay length, and patient satisfaction measures. Statistical analysis employed multivariable logistic regression to control for confounding variables, and Kaplan-Meier analysis assessed recurrence-free survival patterns. Results demonstrated significantly lower 24-month recurrence rates in the mesh group compared to non-mesh repair (2.5% versus 11.6%, p = 0.003). The relative risk reduction was substantial at 0.22 (95% CI: 0.07-0.65), with a number needed to treat of 11 patients. This benefit proved particularly pronounced for defects measuring 2 cm or larger (3.2% versus 16.2%, p = 0.001), while mesh repair required longer operative time (52.3 versus 38.7 minutes, p<0.001), no significant differences emerged in 30-day complications, hospital stay duration, chronic pain incidence, or patient satisfaction scores between groups. These findings support the preferential use of mesh repair for umbilical hernias, especially in patients with larger fascial defects, within resource-limited healthcare settings. The evidence advocates for integrating mesh-based techniques into national surgical guidelines for similar healthcare environments.